Wounds occur when the integrity of any tissue is compromised, affecting one or more layers of skin. Wounds may be caused by an act, surgical procedure, an infectious disease or an underlying condition. Examples of open wounds include punctures, abrasions, cuts, lacerations and burns. Chronic wounds are also common ailments and include pressure ulcers, diabetic ulcers, arterial ulcers, venous ulcers or combination of all the above. Despite much progress made in the wound care industry, an efficient and effective method and apparatus for protecting the wound from injurious contacts is not readily available.
Injurious contacts with foreign objects may be caused from various sources, ranging from brushing of clothing or bed sheets to fresh, uncovered wounds to adherence of wound dressing to the wound. The latter issue, referred to here as the sticking issue, leads to deleterious consequences for the patient. This problem is particularly exacerbated when wounds are left unattended for a substantial period. It is reported that in certain circumstances patients are administered morphine to withstand the pain caused form dressing removal, especially with wounds having a large surface area. Equally important, tearing of skin graft, newly formed cells or scab adhered to dressing disrupts the healing process.
The main reason for covering the wound with dressing is to prevent contamination and resulting infection. Wounds may also be covered for other reasons, including retaining moisture and absorption of exudate. Wound covering has traditionally consisted of application of dressings that are in direct contact with the wound. When directly applied on the wound, dressings adhere and mechanically anchor to wound surface, which may include diffused wound fluid, skin graft, new epidermal cells forming over the wound or the scabby covering of the wound.
The sticking issue has traditionally been addressed by soaking the wound and the dressing adhering to it in water for sometime to soften the scab and make removal easier. Another method is the application of antibiotic ointments, such as polymyxin B sulfate or bacitracin, to keep the bandage from sticking to the wound. These methods, however, have not sufficiently addressed the sticking issue. As can be appreciated by health care professionals, soaking in water or application of ointments are not always practicable or recommended.
To better address the sticking issue the medical industry has developed “non-stick” dressings such as Telfa® and Xeroform®. Non-stick, however, is a relative term. Non-stick dressings merely stick less than their traditional counterparts, e.g., cotton gauze. Another problem with these dressings is that their cost is prohibitive for use on wounds requiring constant change of dressing.
“Non-contact” dressings have also been invented to address the sticking issue. These dressings are primarily designed in the shape of an inverted cup or a raised bandage. The general idea is that the space within the cup or raised bandage covers the wound, but does not come in contact with it. Such dressings are described in, e.g., U.S. Pat. Nos. 2,367,690; 2,443,140; 2,443,481; 3,334,626; 4,726,364; 5,817,145; 6,528,697; and 6,570,050.
Similar to the traditional and “non-stick” dressings described above, “non-contact” dressings also fail to efficiently and effectively protect the wound from contact, including addressing the sticking issue. First, they cannot be sufficiently deformed for the specific contours of different wounds, such as a narrow, long laceration. Second, they are designed in specific sizes that are not necessarily the desirable size for the wound.
U.S. Pat. No. 2,443,481 to Sene attempts to address this matter via an isolator having slots cut into its side wall, providing independent tongues in a deformable arrangement that “are easy to displace by reason of their flexibility and may follow readily the outline of the wound to be treated . . . . ” See Sene at Col. 3:19-30, FIG. 3. More recently, U.S. Pat. No. 6,528,697 to Knutson attempted to address this problem in a similar manner, by providing a standoff with notches on its side wall that may be deformed or bent to the size and for the contours of the wound. See Knutson at Col. 6: 17-60, FIGS. 7A-7D. No matter how deformable or flexible their “tongues” or “notches” may be, both Sene and Knutson are limited in how much and how well they can follow the outline of the wound. In addition, their deformability and flexibility can only expand their size to a finite amount. Thus, they are inherently limited in size and constrained in their ability to specifically conform to the contour of the wound. Furthermore, the slots or notches cut in their side walls allow for diffusion of exudate from the wound on to adjacent areas. These references address this latter issue by adding more parts to their apparatus, which in turn makes them more complex, difficult to use and cost prohibitive.
Knutson also attempts to addresses the size and deformability issue by bundling several size dressings in one package. See Knutson at FIGS. 5 and 6. Aside from the fact that the myriad of sizes offered may still fail to provide the appropriate size for the wound, with such bundled package many dressing sizes in the package may never be used—a waste of financial resources.
Aside from their size limitation and lack of deformability, the prior art “non-contact” dressings have other drawbacks. Their complicated design makes their costs a prohibitive factor and application difficult. In addition, with wounds for which the purpose of a non-contact bandage is primarily protection from physical contact, including prevention of dressing from adhering to the wound bed, the prior art non-contact dressings are unnecessarily too complicated and an overkill. Moreover, whether several dressing sizes bundled together, or more than one dressing is in use, the prior art non-contact dressings are unable to address wounds on body segments with small surface areas. For example, using a large square, oval or circular bandage to cover a large, narrow and oddly shaped laceration on the forearm or shin is impractical. The same is true for the face and neck regions. Similarly, due to their specific shape and size, the non-contact dressings of prior art are not able to address wounds located in joints, such as elbows or knees.
Thus, the need exists for a wound apparatus and application method that more effectively protects the wound from injuries caused by contact, including addressing the problem of dressing adhering to wound surface.